Characteristics and Hiv Risk Behaviors Among Injection Drug Users in St. Petersburg, Russia: A Comparison of Needle Exchange Program Attenders and Nonattenders

Summary

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The purpose of this descriptive study was to compare young Russian NEP attenders (N = 209) and nonattenders (N = 207) on a multitude of dependent variables related to drug and sexual knowledge, attitudes, and behaviors. Questionnaire data found NEP attenders were more likely to be female, inject more frequently, use heroin heavily, be in long-term relationships, use clean needles, have more unprotected vaginal sex acts, and have drug-using friends with positive safer sex attitudes. Comparisons were also made between male and female NEP attenders, male NEP attenders and nonattenders, female NEP attenders and nonattenders, and male and female NEP nonattenders. Significant differences between those subgroups were found. A logistic regression was run to determine which variables served to predict NEP attendance. Four variables accounted for 17% of the variance and predicted NEP attendance in two thirds of the cases: safer sex attitudes of drug-using friends, heroin use, using new needles to inject, and relationship status.

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Characteristics and Hiv Risk Behaviors Among Injection Drug Users in St. Petersburg, Russia: A Comparison of Needle Exchange Program Attenders and Nonattenders

INTRODUCTION

In Russia, the HIV/AIDS epidemic is growing at an alarming rate. Since 1996, the number of officially registered HIV infections has increased from about 200 to more than 140,000 (Pokrovsky, 2001). A recent U.S. intelligence report (Lumpkin, 2002) estimated the number of HIV-infected Russians at over 2 million now, while projecting there would be between 5 to 8 million such infections by 2010. Injection drug users (IDUs) account for 80% to 90% of Russian HIV cases (Bobkov et al., 1997; Bobkov et al., 1998; Kozlov, 2000). Given that HIV is often sexually transmitted, the disease will likely spread to Russia's non-IDU population.

This widespread injection drug use is a relatively recent problem in countries of the former Soviet Union, probably resulting from political upheaval in the region as well as inefficient law enforcement, increased drug availability, the development of well-organized drug-trafficking networks, and a culturally-related fatalism (i.e., not having personal control over how one's life unfolds) prevalent among young, unemployed male IDUs (Amirkhanian, Kelly, & Issayev, 2001 ; Atlani, Carael, Brunei, Frasca, & Chaika, 2000; Denhne, Grund, Khodakevich, & Kobyshcha, 1999; Latyshev & Rechnov, 1998; Daniszewski, 2002). The circumstance has been further complicated by a decline in the dominance and power of the family structure, resulting in greater numbers of Russian youth who are more liberal with respect to sexuality, drug use,and prostitution (Amirkhanian et al., 2001; Kon, 1995; 1997; Latyshev & Rechnov, 1998), a perception among Moscow IDUs that injecting drugs and sharing needles are no longer marginalized activities (Rei...

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